Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YM0800X | Mental Health Counselor | 075177-1 | NY |
NPI | 1003054644 |
---|---|
Provider Name | Ms. Anita Esther La Rosa |
First Address | Jamaica, NY 11434-4918 |
Second Address | Jamaica, NY 11432-4837 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 03/02/2009 |
Last Update Date | 18/04/2013 |